MEDICAL ASPECTS OF CHEMICAL,
BIOLOGICAL, AND RADIOLOGICAL WARFARE
In this chapter we will discuss the history of
chemical, biological, and radiological (CBR) warfare,
and the recognition and treatment of CBR-produced
We will also discuss the Medical
Departments role in meeting the medical aspects of CBR
defense, which includes protection from CBR hazards,
mass casualty decontamination, decontamination
stations, and supplies for decontamination. Table 8-1
provides a summary of CBR symptoms and treatments.
LEARNING OBJECTIVE: Select the
appropriate treatment and decontamination
procedure for chemical, biological, or
The use of chemical agents in warfare, frequently
referred to as gas warfare, is defined as the use of
chemical agents in gaseous, solid, or liquid states to
harass personnel, produce casualties, render areas
impassable or untenable, or contaminate food and
water. The chances of surviving a chemical attack are
increased as knowledge of the nature of the agents and
of the use of correct protective measures is increased.
The first large-scale use of chemical agents came
in World War I when, in 1915, the Germans released
chlorine gas against the Allied positions at Ypres,
Belgium. Over 5,000 casualties resulted. There were
other gas attacks by both combatant forces during
World War I, and it is well documented that
approximately one-third of all American casualties in
this conflict were due to chemical agent attacks.
During the interval between World Wars I and II,
each of the major powers continued to develop its
capability for chemical warfare, in spite of a ban by the
Geneva Treaty. In isolated cases in the late 1930s,
toxic chemicals were used; however, they were not
used during World War II. Nor were toxic chemicals
authorized for use in Korea, Vietnam, or Desert Storm.
Defoliants and riot-control agents were used with
some degree of effectiveness in the jungles
of Vietnam, in tunnel and perimeter-clearing
Chemical agents are dispersed by modern
weapons for strategic as well as tactical purposes.
However, the areas of their use are limited by the range
of the weapons or aircraft used by the combatant force.
A naval unit afloat finds itself in a unique situation
with respect to defending against toxic chemical
agents. Agents can be released as clouds of vapor or
aerosol. These can envelope the exterior of a vessel
and penetrate the hull of the ship.
contamination can result from such an attack, and the
ship must be decontaminated while the personnel
manning it continue to eat, sleep, live, and fight on
To properly meet the medical needs of the ship, the
medical officer or Hospital Corpsman on independent
duty must organize the Medical Department well in
advance of the actual threat of a chemical agent attack.
All hands must be indoctrinated in the use of protective
equipment and self-aid procedures, and close liaison
and planning must be maintained with damage control
personnel responsible for area decontamination.
SELF-PROTECTION AND TREATMENT
In a chemical attack, the first priority is to ensure
your own survival so that you may then treat casualties.
There are several items available to help you survive a
chemical attack, and you should know how to use
Along with protective clothing, there is a
protective mask, which should be put on at the first
indication of a chemical attack. The mask will filter
out all known chemical agents from the air and allow
you to work in a chemically contaminated area. A
chemical agent on the skin can be removed effectively
by using the M291 skin decontamination kit (fig. 8-1).
The M291 skin decontamination kit replaces the
M258A1 (fig. 8-2). Upon receipt of the M291,
discontinue use of the M258A1.